How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,023 to $10,000Professionalmedian $427 · 10th to 90th $309 to $955
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,445.44 Median $7,244.36 Typical High $12,302.69 | Facility | None | $1,445.44 | $7,244.36 | $12,302.69 |
Aetna Setting Professional Modifier None (both parts) Typical Low $707.95 Median $2,290.87 Typical High $8,317.64 | Professional | None (both parts) | $707.95 | $2,290.87 | $8,317.64 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $275.42 Median $316.23 Typical High $331.13 | Professional | 26 · Professional part | $275.42 | $316.23 | $331.13 |
Capital Blue Cross Setting Professional Modifier 26 · Professional part Typical Low $288.40 Median $295.12 Typical High $512.86 | Professional | 26 · Professional part | $288.40 | $295.12 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $794.33 Typical High $7,585.78 | Facility | None | $60.26 | $794.33 | $7,585.78 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $275.42 Median $338.84 Typical High $588.84 | Professional | 26 · Professional part | $275.42 | $338.84 | $588.84 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None (both parts) | $4,466.84 | $4,466.84 | $4,466.84 |
Geisinger Setting Professional Modifier None (both parts) Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None (both parts) | $354.81 | $354.81 | $354.81 |
Geisinger Setting Professional Modifier 26 · Professional part Typical Low $309.03 Median $398.11 Typical High $616.60 | Professional | 26 · Professional part | $309.03 | $398.11 | $616.60 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $7,079.46 Typical High $7,762.47 | Facility | None | $1,778.28 | $7,079.46 | $7,762.47 |
Martin's Point Setting Facility Modifier None Typical Low $1,513.56 Median $6,456.54 Typical High $12,589.25 | Facility | None | $1,513.56 | $6,456.54 | $12,589.25 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $707.95 Median $2,454.71 Typical High $8,912.51 | Professional | None (both parts) | $707.95 | $2,454.71 | $8,912.51 |
Martin's Point Setting Professional Modifier 26 · Professional part Typical Low $275.42 Median $316.23 Typical High $331.13 | Professional | 26 · Professional part | $275.42 | $316.23 | $331.13 |
UPMC Health Plan Setting Facility Modifier 26 · Professional part Typical Low $288.40 Median $323.59 Typical High $323.59 | Facility | 26 · Professional part | $288.40 | $323.59 | $323.59 |
UPMC Health Plan Setting Professional Modifier 26 · Professional part Typical Low $288.40 Median $295.12 Typical High $323.59 | Professional | 26 · Professional part | $288.40 | $295.12 | $323.59 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,309.57 | Facility | None | $1,380.38 | $2,398.83 | $6,309.57 |
United Setting Professional Modifier None (both parts) Typical Low $302.00 Median $416.87 Typical High $616.60 | Professional | None (both parts) | $302.00 | $416.87 | $616.60 |
United Setting Professional Modifier 26 · Professional part Typical Low $302.00 Median $416.87 Typical High $616.60 | Professional | 26 · Professional part | $302.00 | $416.87 | $616.60 |
10 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $158.49 Typical High $165.96 | Professional | 52 · Reduced service | $138.04 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $63.10 Typical High $66.07 | Professional | 53 · Discontinued | $56.23 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $234.42 Typical High $251.19 | Professional | 54 · Surgery only | $208.93 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $46.77 Typical High $50.12 | Professional | 55 · Aftercare only | $41.69 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $31.62 Typical High $33.11 | Professional | 56 · Pre-op care only | $27.54 | $31.62 | $33.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $158.49 Typical High $165.96 | Professional | 52 · Reduced service | $138.04 | $158.49 | $165.96 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $63.10 Typical High $66.07 | Professional | 53 · Discontinued | $56.23 | $63.10 | $66.07 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $234.42 Typical High $251.19 | Professional | 54 · Surgery only | $208.93 | $234.42 | $251.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $46.77 Typical High $50.12 | Professional | 55 · Aftercare only | $41.69 | $46.77 | $50.12 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $31.62 Typical High $33.11 | Professional | 56 · Pre-op care only | $27.54 | $31.62 | $33.11 |
Where Pennsylvania sits
The same service costs 23.4 times more in Colorado than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Pennsylvania· 20th of 51
$1,738
CO $6,761KY $288
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.